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支气管镜下钬激光消融联合连续冷冻消融治疗气管插管后组织增生所致气道狭窄:临床病例观察

Bronchoscopic holmium laser ablation continuous cryoablation for the treatment of airway stenosis caused by tissue hyperplasia after tracheal intubation: clinical case observation.

作者信息

Yang Qingjie, Lv Shenghua, Li Qingtian, Lan Linhui, Sun Xiaoyan, Feng Xinhai, Han Kaibao

机构信息

Department of Thoracic Surgery, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, China.

出版信息

J Thorac Dis. 2024 Jul 30;16(7):4693-4701. doi: 10.21037/jtd-24-67. Epub 2024 Jul 23.

DOI:10.21037/jtd-24-67
PMID:39144344
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11320264/
Abstract

This study aimed to design a standardised bronchoscopic holmium laser ablation continuous cryoablation for the treatment of airway stenosis caused by tissue hyperplasia after tracheal intubation and to retrospectively analyse its safety and feasibility. We collected the data of patients who had undergone bronchoscopic holmium laser ablation continuous cryoablation due to airway stenosis caused by tracheal mucosal tissue hyperplasia after tracheal intubation. The patients' baseline characteristics, ablation effects, surgical complications and other data were analysed. In total, 16 patients were enrolled in this study. On average, airway stenosis occurred 96.00 (interquartile range, 69.75-152.50) days after tracheal intubation and bronchoscopic holmium laser ablation continuous cryoablation took an average of 90.38 minutes (standard deviation: 16.78). After the first continuous cryoablation, 75.0% (12/16) of the patients had complete ablation of hyperplastic tissue, and 25.0% (4/16) had most of the hyperplastic tissue (>50%) removed. Altogether, 18.75% (3/16) and 6.25% (1/16) of the patients had complete ablation of hyperplastic tissue after the second and third cryoablation, respectively. Moreover, one patient (6.25%) had minimal wound bleeding postoperatively, and no other surgical complications occurred. No airway stenosis was found in all enrolled patients during follow-up 1 and 6 months after the last cryoablation. According to the above results of our small sample study indicated that bronchoscopic holmium laser ablation continuous cryoablation seems safe and effective for treating airway stenosis caused by tissue hyperplasia after tracheal intubation.

摘要

本研究旨在设计一种标准化的支气管镜钬激光消融联合连续冷冻消融术,用于治疗气管插管后组织增生所致气道狭窄,并回顾性分析其安全性和可行性。我们收集了因气管插管后气管黏膜组织增生导致气道狭窄而接受支气管镜钬激光消融联合连续冷冻消融术患者的数据。分析了患者的基线特征、消融效果、手术并发症等数据。本研究共纳入16例患者。气管插管后气道狭窄平均发生于96.00(四分位间距,69.75 - 152.50)天,支气管镜钬激光消融联合连续冷冻消融术平均耗时90.38分钟(标准差:16.78)。首次连续冷冻消融后,75.0%(12/16)的患者增生组织完全消融,25.0%(4/16)的患者大部分增生组织(>50%)被清除。第二次和第三次冷冻消融后,分别有18.75%(3/16)和6.25%(1/16)的患者增生组织完全消融。此外,1例患者(6.25%)术后伤口有少量出血,未发生其他手术并发症。在最后一次冷冻消融术后1个月和6个月的随访中,所有纳入患者均未发现气道狭窄。根据我们小样本研究的上述结果表明,支气管镜钬激光消融联合连续冷冻消融术治疗气管插管后组织增生所致气道狭窄似乎安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adc3/11320264/b965ba41593a/jtd-16-07-4693-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adc3/11320264/b965ba41593a/jtd-16-07-4693-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adc3/11320264/b965ba41593a/jtd-16-07-4693-f1.jpg

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Outcome of Post-intubation Tracheal Stenosis (PITS) with Primary Resection and Anastomosis.经气管插管后气管狭窄(PITS)的原发性切除和吻合术的结果。
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